Novel treatment options in depression and psychosis
Neuropsychiatric Disease and Treatment March 1, 2018 Eva Češková, Petr Šilhán
Current treatment for severe mental disorders remains suboptimal. Improvement comes from both new procedures and optimizing existing ones, including therapeutic drug monitoring. New pharmacological options include more sophisticated monoaminergic drugs, rediscovered older drugs, and agents targeting novel mechanisms. For depression, treatment resistance is a major challenge; switching to multimodal antidepressants or augmenting with atypical antipsychotics like aripiprazole and brexpiprazole shows promise, as do nutraceuticals, ketamine, and opioids. Antipsychotics remain central for schizophrenia; new partial dopamine agonists brexpiprazole and cariprazine join aripiprazole, and long-acting injectable formulations of aripiprazole lauroxil and 3-month paliperidone palmitate are now available. Emerging options include cannabidiol, glutamate modulators, and nicotine receptor agonists.